| NPI | 1932949666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 53-83229-102) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2024002803) |
| Enumeration Date | 2024-05-30 |
| Last Update Date | 2024-05-30 |